NephMadness 2014 Part 1- Hypertension Bracket

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So it is that time of the year again, NephMadness 2014! I am hoping it doesn’t distract me too much from the basketball…
This year’s bracket has thrown up some very interesting match ups. I had a really hard time deciding who goes through in each round. I hope our RFN readers will allow me to indulge myself and do what everyone is told NOT to do in medical school and residency, namely, review a review [article]!

For me the biggest match up was in the hypertension bracket, ACEi/ARBs vs Renal Artery Tx, there was blood on the court! Renal artery ablation was gaining almost legendary status with the potential for it to have a significant impact in the treatment of severe hypertension (SIMPLICITY-1, SIMPLICITY-2). The treatment was safe and would reduce the need for polypharmacy and the associated side effects. Furthermore, with our tried and trusted antihypertensives and ablation therapy, the vast majority of hypertensives could be treated. The early withdrawal of SIMPLICITY-3 shattered all these hopes. This news created a big stir not only in the nephrology community but the whole medical community. Their opponents are also heavy hitters. A member of every family in the western world probably takes ACEi/ARBs! They have had a huge impact in nephrology and the wider cardiovascular population. Even though SIMPLICITY-3 was never completed it was such big news that it dominated the tournament for me and went all the way.

Other big news this year was the long awaited JNC8 report. This had been in the pipeline for years but when it arrived it was not well received by everyone. Some members of the committee even went so far as to publish their concerns about the recommendations. A minority of the panel had concerns about raising the SBP target in over 60s (without DM or CKD) from 140 to 150mmHg.

Please leave a comment telling us about your highlights from this years NephMadness!

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